Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients

Ana Carolina Veronese Silva; Tainá Júlia Tumelero; Danielle Reis Yamamoto; Sabine Kruger Truppel; Giovana Stival da Silva; Luciana Bandeira Mendez Ribeiro; Patricia Zacharias; Marcia Olandoski; Daniela Oliveira Magro; Mário César Vieira; Paulo Gustavo Kotze

doi:10.1016/j.gastrohep.2023.10.006

Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients

Gastroenterol Hepatol. 2023 Oct 26:S0210-5705(23)00452-1. doi: 10.1016/j.gastrohep.2023.10.006. Online ahead of print.

[Article in English, Spanish]

Affiliations

¹ Health Sciences Postgraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil. Electronic address: ana.carolina.v.s@hotmail.com.
² Health Sciences Postgraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
³ Pediatric Gastroenterology Unit, Pequeno Príncipe Hospital, Curitiba, Brazil.
⁴ Biostatistics, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
⁵ Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.

PMID: 37890582
DOI: 10.1016/j.gastrohep.2023.10.006

Abstract

Objective: Compare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)-Crohn's disease (CD) and ulcerative colitis (UC)-patients.

Patients and methods: Observational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015-2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test.

Results: A total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; P=0.129), surgery (46.6% vs. 50.8%; P=0.419), or hospitalization (64.9% vs. 56.9%; P=0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; P=0.048) and hospitalization (47.4% vs. 24.0%; P<0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; P=0.219).

Conclusions: Biological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.

Keywords: Anticuerpos monoclonales; Cirugía colorrectal; Colitis ulcerosa; Colorectal surgery; Crohn's disease; Enfermedad de Crohn; Humanized monoclonal antibodies; Pediatric; Pediatría; Ulcerative colitis.